Medicare Supplement – Medigap Basics

Medicare Supplement & Medigap Basics

Medigap information can be confusing and overwhelming. Even the terms Medicare Supplement, Medigap, and Medicare Advantage can get make you scratch your head.

This list of information will help you get started on the right foot.

First things first. Medicare Supplements and Medigap policies are the same exact thing. These terms are interchangeable. There is no difference. We will use the term Medigap for all Medicare Supplement information on this page.

Medigap is not Medicare Advantage (also referred to as MAPD) however. They are completely different types of insurance. Medigap comprehensive coverage unlike MAPD plans. You can also check our quick Medicare Basics summary to learn the basic benefits of Medicare Parts A, B, C, and D.

Your Medigap policy will always be in force for as long as you pay your premiums. Your policy cannot be cancelled by the insurance company unless you stop paying your premiums. Get a complimentary copy of the official Medicare and You Handbook to stay on top of other important details (or just contact us and we’ll answer any of your questions).

There are no co-pays with Medigap Plan F. This means no copays when you go to your doctor, or any other doctor, emergency room or hospital anywhere in the United States. Plan N will have copays of up to $20 for doctor visits and up to $50 for an ER visit. The $50 is waived if you are admitted into the hospital.

Comparing Plans Is Key! Learning how to compare medicare supplement plans correctly will save you money now and in the future. If you think name brand companies provide better coverage, you’re mistaken. This is just one of the basic mistakes people make when shopping plans.

Premium Prices Vary Significantly. Make sure you understand how your Medicare Supplement premiums. Read this comprehensive post on the cost of Medicare Supplements and how they vary.

An “Open Enrollment” period occurs when you are first enrolled in Part B of Medicare. It lasts for 6 months. During this time you can purchase a Medigap policy without having to answer health questions.

Medigap policies allow you to choose any doctor and any hospital anywhere in the USA. There are no networks with Medigap. Referrals and pre-authorizations are not needed to see your doctor or to be admitted to a hospital. Medigap allows you to be in charge of your health care.

All companies offering Medigap policies file their claims automatically. If your procedure is a Medicare Approved Claim, the Medigap company must pay it. You should not have to worry about filing a claim with Medicare or your insurance company.

Medicare has an annual deductible for Part B charges. Some policies (Plan F) pay this deductible but at a higher cost to you. You may pay more money in additional premium each year if you select a Plan F policy that provides this benefit. Plan G will save you money. We can show you how.

Typically Medicare does not pay for routine Nursing Home Care. Be sure you thoroughly understand the Skilled Nursing Benefit in Part A of Medicare.

Medigap insurance companies will pay all of your claims, but those claims must first be approved by Medicare. Your Medigap policy will not pay if your claim is not approved by Medicare.

Check with your doctors to see if they “Accept Assignment” before purchasing the Medigap Policy. Most doctors “Accept Assignment”, but if they don’t, you may have to pay for excess charges with some plans. If they accept assignment, you can save extra money. Medigap plans that pay for Excess Charges are more expensive than those that don’t. We can help you with this.

When replacing (switching from one Medigap policy to another) you may have to answer health questions to get the new policy. These health questions differ from company to company. You may qualify for a lower premium even if you have health issues.

Be An Informed Medigap Shopper

Insurance agents work on straight commission. The more expensive the policy you purchase the higher the commission. Please make sure that the agency you work with has your best interests in mind and not the amount of commission they will make.

We have developed our agency so our clients are always aware of the lowest rates of all the top insurance companies. It’s how we choose to conduct our business.

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Hello, my name is Joann Quinn and I'm the co-founder of REMEDIGAP.com and a licensed independent insurance agent in multiple states. I've written over 50 articles about Medicare and Medigap insurance. My goal is to make Medicare and Medigap less confusing. I know Medicare seems overly complicated, but with some guidance you'll gain the confidence you need to make important decisions about your benefits.